Medical researchers in Japan say they will start the world’s first clinical studies of a radiation therapy using accelerator-based neutron beams to kill cancer cells.

The National Cancer Centre in Tokyo and a Japanese medical equipment maker -- Cancer Intelligence Care Systems -- plan to start the studies using "boron neutron capture therapy (BNCT)" in three years, the centre said.

The BNCT is an innovative radiation treatment which kills cancer cells selectively without side-effects, but it requires a massive facility including a nuclear reactor to produce neutron beams.

By using a particle accelerator, which is cheaper, safer and smaller than a reactor, it will become feasible for a hospital to provide the therapy on actual patients, the centre told journalists Tuesday.

The centre hopes to try the special radiation therapy on patients with cancers that have been difficult to treat in conventional procedures, such as brain tumors and melanoma, it said.

The boron neutron capture therapy(BNCT) is a promising method of cancer treatment in principle, which kills cancer cells selectively by the use of cancer seeking boron compound and the neutron irradiation. Source

Boron neutron capture therapy (BNCT) is an experimental way of giving radiotherapy that has been used in trials with glioblastoma multiforme (grade 4 glioma). There are concerns that the treatment causes severe side effects, so trials continue in Europe and the USA. The trials are looking into using this treatment after surgery to try to reduce the risk of the brain tumours coming back.

BNCT is really a combination of treatment with boron and fast neutrons. Radiotherapy using neutrons can get rid of glioblastoma cells. Unfortunately, at the dose needed to do this, too much damage is caused to healthy brain tissue.

In BNCT, boron is injected into the bloodstream and collects in tumour cells. The next stage of the treatment is external radiotherapy with low energy neutrons. The boron molecules give off radiation within the brain tumour cells when the external neutron radiation hits them. This enhances the radiation dose by about 2 or 3 times. So, a lower dose of neutron radiotherapy can be given. This makes it less likely that the neutrons will cause damage.

Unfortunately, there have been reports of damage being caused by the boron in the brain. This was an unexpected complication and more research needs to be done to confirm or deny this. There are no trials for patients going on in the UK at the moment. BNCT research is going on here, but it is still at the pre-clinical (laboratory) stage. Hopefully, this will lead to an early phase clinical trial soon.

There is an early phase trial in the US for people with newly diagnosed glioblastoma multiforme. The trial is testing BNCT with a chemotherapy drug called temozolamide. Early phase trials look at side effects, doses and whether there seems to be a response for a particular cancer. It is only in later phase 3 trials that we can see if a new treatment works any better than an existing treatment. So it will be some years before we have any long term results for BNCT.

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